Those working in the health care field are facing challenging times with the roll-out of the Affordable Care Act and Gov. Chris Christie’s recent decision to expand New Jersey’s Medicaid system. Barnabas Health President and CEO Barry Ostrowsky told NJ Today Managing Editor Mike Schneider that the changes have been chaotic for those in the industry who are trying to figure out the best course of action.
Although the Affordable Care Act, commonly referred to as “Obamacare,” has been discussed for some time, Ostrowsky said there hasn’t been clarity for providers. “I think what we’re still concentrating on is how to be most efficient and how to expand accessibility. And that’s a difficult thing regardless of the statutory construct. We have to make sure that our facilities, our physicians, our services are available to a maximum number of people,” he explained. “And for the most part we haven’t been given a great deal of guidance about that so we’re busy trying to make sure that all the people who need services will be getting services.”
Ostrowsky said he applauds Christie’s decision to expand Medicaid. “I think that is one of those elements of expanding accessibility. I think the more people you can bring into the health care delivery system, the more you can attend to their problems, the better chance we have of curing conditions and illnesses that they have,” he said.
Ostrowsky said he would like to move health care from sickness care to supporting a better lifestyle. He believes expanding Medicaid to include more patients will allow health care providers to have wellness discussions with more people.
Some in the industry have criticized Medicaid payments for not covering the cost of care. Ostrowsky said the program pays a percentage of the cost and that private insurance companies are paying more of the cost.
“I think eventually we have to meet in the middle. We have to reduce our costs, making the Medicaid reimbursement closer to cost,” Ostrowsky said. “And I think with some patient participation in taking care of themselves I think we’ll bridge that gap. Believe me, I would prefer to get much higher prices for what we do develop and deliver. But it’s not gonna happen and we have to be realistic about that.”
Ostrowsky said his company sees patients who use the emergency department in place of primary care physicians. He refers to that phenomenon as deferral of care, which he said is costly.
“If you’re outside the system and don’t have a primary care physician or feel that you can’t afford to call a primary care physician, you present at the emergency department long into the condition or illness. And that’s a much more expensive way to treat people,” Ostrowsky explained.
He said the tricky piece is how to triage individuals, saying some might not want to be told where to get their care. “How do you say to someone, ‘No you shouldn’t go to the emergency department. You need to go to an urgent care center or an unscheduled doctor’s office’? That technique is very difficult and some people will react I think poorly to being told where he or she can get care,” Ostrowsky said.
Hurricane Sandy affected Barnabas Health employees since some of the company’s facilities are located at the Jersey Shore. According to Ostrowsky, more than 400 employees lost their homes because of the storm. Despite the personal tragedies, he said employees continued to work and the buildings continued to operate.
“So amidst their own personal tragedies, they swam to work, they boated to work, they came to work to help others. So we experienced that. But the stories are just awful and the healing has just begun. And I have to tell you we’ve been advised that the healing will take a much longer period of time than most of us think and so we’re living with it every day,” Ostrowsky said. “But I can’t say enough about the spirit and the commitment and dedication of health care workers.”